Awareness about Aphasia

Dr. Stark wrote this short blog post on March 31, 2022, in response to Bruce Willis’ diagnosis of aphasia

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Aphasia is a disorder that affects language: the way we speak, understand, write, and read. For example, it can affect our ability to find words, understand sentences, process letters, and understand the ‘meaning’ of things. Aphasia affects over 2 million people in the USA alone, and can result from an acquired brain injury (most commonly, a stroke, but also a variety of other acquired brain injuries such as traumatic brain injury), or from a neurodegenerative disease (such as Alzheimer’s disease). Language is organized largely in the left hemisphere of the brain, in the frontal, temporal and parietal regions. When one has an acquired brain injury or a neurodegenerative disease affecting some or all of these regions, aphasia results. For acquired aphasia, aphasia typically persists chronically in about 33% of people. Given the average age of stroke in the USA is ~65 years, this means that many people are living with aphasia for several years beyond their stroke. There are several types and severities of acquired aphasia, such as Broca’s aphasia. The type and severity of aphasia tell us about the kind of language processes affected (e.g., speaking is affected more than understanding in Broca’s aphasia), and how severely those language processes are affected. For the neurodegenerative type of aphasia, “Primary Progressive Aphasia [PPA],” this disorder typically starts after age 50, with most occurrences happening in the 60s, 70s, and 80s. There are three recognized variants of PPA. We typically think of neurodegenerative diseases like Alzheimer’s disease as affecting memory, or perhaps personality, but in the case of people with PPA, the first and most primarily affected function is language. In Logopenic PPA, the most common cause is Alzheimer’s disease, and this variant is characterized by issues in finding words whilst speaking. In Nonfluent/Agrammatic PPA, the most common cause is the build-up of tau protein (part of the Frontotemporal Dementia Spectrum) or Alzheimer’s disease. This variant is characterized by slowed motor planning and execution (e.g., difficulty organizing the mouth muscles to speak), and impaired use of grammar (e.g., using simple sentences). Finally, Semantic PPA , which is most commonly caused by a build-up of the protein TDP-43 (and is also considered a part of the Frontotemporal Dementia Spectrum) is characterized by impaired understanding, as well as losing the meaning of things. For example, they may forget “what” a phone is, or how to use a phone.

It is very important to seek treatment for both acquired aphasia and PPA. For both disorders, the gold standard of treatment is speech therapy. There are a variety of resources for speech therapy in Indiana, linked below. For PPA, the first step is to receive a confirmatory diagnosis from a neurologist, and it is recommended to seek a neurologist who specializes in dementias. The goal of treating acquired aphasia is to restore language function whilst the goal of treating PPA is to train and therefore retain language function for as long as possible. Since this is a degenerative disorder, it is understood that language (and other cognitive faculties, such as memory) will eventually decline over time, but speech therapy has been demonstrated to help slow down this process. Neurologists can also recommend pharmacological treatments that may be helpful. The ultimate goal of treating any aphasia is to promote independent living and quality of life.

 

Brielle C. Stark, PhD

Assistant Professor of Speech, Language and Hearing Sciences at Indiana University Bloomington

Core Faculty in the Program in Neuroscience, Affiliated Faculty in Cognitive Science Program

 

Background:

Dr. Stark received her BA in Psychology from Bryn Mawr College, and received her PhD in Clinical Neurosciences from Cambridge University (UK), where she was a Gates Cambridge Scholar. She then completed a postdoctoral fellowship at the Center for the Study of Aphasia Recovery at the University of South Carolina and joined IU’s faculty in 2018. She currently directs the NEURAL Research Lab at IU, where they conduct neuroscience and behavior research on aphasia. She also co-founded FOQUSAphasia (www.foqusaphasia.com), an international working group aiming to improve evidence for studying spoken language in aphasia. She is happy to discuss anything related to aphasia, and be reached at bcstark@iu.edu. Her lab is presently recruiting individuals with acquired aphasia to take part in several studies, and more information can be found on the NEURAL Research Lab website (www.neuralresearchlab.com) or by emailing Dr. Stark.

Her publications and recorded talks/podcasts/lectures on Aphasia can be found for free on her website: https://www.neuralresearchlab.com/open-resources

 

Interested in more?

 

Brielle Stark